Provider Demographics
NPI:1831478528
Name:KO, JOCELYN (MD)
Entity type:Individual
Prefix:
First Name:JOCELYN
Middle Name:
Last Name:KO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1916 PIKE PLACE STE 12 #443
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1056
Mailing Address - Country:US
Mailing Address - Phone:917-319-8677
Mailing Address - Fax:
Practice Address - Street 1:1334 TERRY AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101
Practice Address - Country:US
Practice Address - Phone:206-682-2661
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-11
Last Update Date:2025-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV24954207R00000X
TXV6337207R00000X
NMMD2014-0525207R00000X
CO0073451207R00000X
CAA141259207R00000X
AZ49046207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine